Effects of occupational exposure to arsenic on the nervous system: Clinical and neurophysiological studies

Objectives: A number of metals, especially heavy metals, exhibit neurotoxic properties. Neurological and neurophysiological studies indicate that the functions of the central (CNS) and peripheral nervous system (PNS) may be impaired under conditions of exposure to arsenic (As). The aim of the present study was to assess the effects of inorganic arsenic on the central and peripheral nervous system. Materials and Methods: The study covered a group of 21 male workers (mean age: 41.9 yr; SD: 7.6; range: 31-55 yr) employed in a copper smelting factory. Their employment duration ranged from 5 to 33 years (mean: 18.1 yr; SD: 7.8). Arsenic concentrations in workplace air amounted to 0.01003 mg/m3 on average (SD: 0.00866). Urine arsenic concentrations ranged from 3.48 to 23.63 μg/l (mean: 11.91 μg/l; SD: 9.5). The control group consisted of 16 males non-occupationally exposed to As, matched for gender, age and work shift pattern. The evaluation of neurological effects was based on the findings of neurological examination, electroencephalography (EEG), visual evoked potentials (VEPs) and electroneurography (ENeG). Results: Clinical symptoms, such as sleeplessness or sleepiness, irritability, headache, painful spasms in extremity muscles, extremity paresthesia and pain, and muscular fatigue prevailed among functional disorders of the nervous system in workers chronically exposed to As. Neurological examination did not reveal any organic lesions in the CNS or PNS. In EEG records classified as abnormal, generalized changes were most common. VEP examinations revealed abnormalities in evoked response latency. Stimulation of the motor fibers of the peroneal and medial nerves resulted in a decreased amplitude of the motor potential. Stimulation of the sensory fibers of medial nerves brought about a decreased amplitude of the sensory potential and a lower conduction velocity of the sural nerves. Conclusion: The findings of the study indicate that exposure to As concentrations within the threshold limit values (TLV) can induce subclinical effects on the nervous system, especially subclinical neuropathy.